Drugs which shorten qt interval

Mechanism of action of a novel human ether-a-go-go-related gene channel activator. Mol Pharmacol. The short QT syndrome as a paradigm to understand the role of potassium channels in ventricular fibrillation.

Nicorandil suppresses a hump on the monophasic action potential and torsade de pointes in a patient with idiopathic long QT syndrome. Jpn Heart J. Congenital long QT syndrome. Orphanet J Rare Dis. Increased risk of cardiac death in primary hyperparathyroidism: what is a role of electrical instability?

Int J Cardiol. Biochem Soc Trans. Primidone in the treatment of the long QT syndrome: QT shortening and ventricular arrhythmia suppression. Ann Intern Med. Br J Clin Pharmacol. Pflugers Arch. Amplified transmural dispersion of repolarization as the basis for arrhythmogenesis in a canine ventricular wedge model of short QT syndrome. Electrocardiographic biomarkers of ventricular repolarisation in a single family of short QT syndrome and the role of the Bazett correction formula.

Am J Cardiol. Pacing Clin Electrophysiol. Fatal QT interval. Am J Emerg Med. Congenital deafness associated with electrocardiographic abnormalities, fainting attacks and sudden death. A recessive syndrome. Quart J Med. Genetical aspects of the cardio-auditory syndrome of Jervell and Lange-Nielsen congenital deafness and electrocardiographic abnormalities Ann Hum Genet.

J Cardiovasc Electrophysiol. Clin Cardiol. Novel mechanism associated with an inherited cardiac arrhythmia: defective protein trafficking by the mutant HERG GS potassium channel. Short QT syndrome: a familial cause of sudden death. Distribution and prognostic significance of QT intervals in the lowest half centile in 12 apparently healthy persons. Short QT syndrome: clinical findings and diagnostic-therapeutic implications. Eur Heart J. Prog Biophys Mol Biol.

Idiopathic short QT interval: a new clinical syndrome? Pharmacological activation of rapid delayed rectifier potassium current suppresses bradycardia-induced triggered activity in the isolated guinea pig heart. J Pharmacol Exp Ther. J Pharmacol Toxicol Methods. Sudden unexpected death in epilepsy: impact, mechanisms, and prevention.

Cleve Clin J Med. Congenital deaf-mutism, functional heart disease with prolongation of Q-T interval and sudden death.

Am Heart J. IKr channel blockade to unmask occult congenital long QT syndrome. Identification of a possible pathogenic link between congenital long QT syndrome and epilepsy. J Am Coll Cardiol. QT interval analysis in patients with chronic liver disease: a prospective study. Electrophysiologic and arrhythmogenic effects of the potassium channel agonist BRL in anesthetized dogs. J Cardiovasc Pharmacol. Further evidence of inherited long QT syndrome gene mutations in antiarrhythmic drug-associated torsades de pointes.

Congenital deaf-mutism, prolonged Q-T interval, syncopal attacks and sudden death. N Engl J Med. A combined abnormality in heart rate variation and QT corrected interval is a strong predictor of cardiovascular death in type 1 diabetes. Biochem Biophys Res Commun. The imprecision in heart rate correction may lead to artificial observations of drug induced QT interval changes. Electrocardiographic reference ranges derived from 79 ambulatory subjects. Short QT syndrome: should we push the frontier forward?

Antiarrhythmic properties of a neuroleptic butyrophenone, melperone, in acute myocardial infarction. A double-blind trial. Acta Med Scand. Two cases of short QT interval. Measurement of the QT interval and the risk associated with QTc interval prolongation: a review. The QT interval and torsade de pointes. Drug Safety. Shortened QT interval: a distinctive feature of the dysautonomia of chronic fatigue syndrome.

Prolongation of QTc interval in patients with Parkinson's disease. Eur Neurol. Beat-to-beat variability of repolarization: a new parameter to determine arrhythmic risk of an individual or identify proarrhythmic drugs.

Anadolu Kardiyol Derg. QT prolongation and torsades de pointes among methadone users: reports to the FDA spontaneous reporting system. Organising evidence on QT prolongation and occurrence of torsade de pointes with non-antiarrhythmic drugs: a call for consensus. Eur J Clin Pharmacol. Safety of non-antiarrhythmic drugs that prolong the QT interval or induce torsade de pointes: an overview. Low penetrance in the long-QT syndrome: clinical impact.

The long QT syndrome. Risk stratification in the long-QT syndrome. Circ Res. The shortage of short QT intervals. Comparison of proarrhythmogenic effects of two potassium channel openers, levcromakalim BRL and nicorandil RP : a high-resolution mapping study on rabbit heart. Dispersion-based reentry: mechanism of initiation of ventricular tachycardia in isolated rabbit hearts. Am J Physiol. Handb Exp Pharmacol. Long QT syndrome: reduced repolarization reserve and the genetic link.

Clinica Pediatrica. Molecular genetics of the long QT syndrome: two novel mutations of the KVLQT1 gene and phenotypic expression of the mutant gene in a large kindred.

Hum Mutat. QT intervals as an index of high serum calcium in hypercalcemia. J Natl Med Assoc. The congenital long QT syndromes from genotype to phenotype: clinical implications. Pharmacological activation of normal and arrhythmia-associated mutant KCNQ1 potassium channels. The significance of QT interval during drug development. Pharmacogenetic aspects of drug-induced torsade de pointes: potential tool for improving clinical drug development and prescribing. Interpretation of clinical ECG data: understanding the risk from non-antiarrhythmic drugs.

In: Morganroth J, Gussak I, editors. Drug Saf. Cardiac repolarisation and drug regulation: assessing cardiac safety 10 years after the CPMP. Evaluating the QT-liability of a drug during its development.

Pharm Med. Haemodynamic and metabolic effects of the antiarrhythmic drug melperone during acute left ventricular failure in dogs. J Mol Cell Cardiol.

Beat-to-beat variability of repolarization differentiates the extent of torsadogenic potential of multi ion channel-blockers bepridil and amiodarone. Eur J Pharmacol. Short QTc in epilepsy patients without cardiac symptoms. Med J Malaysia. Beat-to-Beat variability of repolarization determines proarrhythmic outcome in dogs susceptible to drug-induced torsades de pointes. Potassium channel openers and blockers: do they possess proarrhythmic or antiarrhythmic activity in ischemic and reperfused rat hearts?

Drugs and trafficking of ion channels: a new pro-arrhythmic threat on the horizon? The effect of changes in core body temperature on the QT interval in beagle dogs: a previously ignored phenomenon, with a method for correction. The clinical utility of QT interval assessment in diabetes. Diabetes Nutr Metab. Long QT syndrome. Cardiol Clin. The long-QT syndrome — bedside to bench to bedside. The spectrum of symptoms and QT intervals in carriers of the gene for the long-QT syndrome.

Is idiopathic ventricular fibrillation a short QT syndrome? Comparison of QT intervals of patients with idiopathic ventricular fibrillation and healthy controls. A new familial cardiac syndrome in children. J Irish Med Assoc. Allelic variants in long-QT disease genes in patients with drug-associated torsades de pointes.

Effect of chronic beta-blockade on QT interval in patients with liver cirrhosis. J Hepatol. Close monitoring is particularly necessary when choosing to use QT-prolonging drugs within this population of patients at risk.

Patients should be counseled about the potential risks associated with these medications and informed of the symptoms of arrhythmia. Patients should seek medical attention if symptoms such as lightheadedness, dizziness, palpitations, shortness of breath, or syncope occur. Conclusion Although QT prolongation has been linked to the use of certain drugs, it remains difficult to predict the relative risk associated with their administration.

Pharmacists can make recommendations to clinicians to help promote safer prescribing practices when selecting QT-prolonging drugs. Drugs that have QT-prolonging effects should not exceed recommended dosing range, as drug-induced arrhythmia is often a result of high drug concentrations.

In addition, these medications should be prescribed with caution in patients who have underlying risk factors, such as cardiac disorders. Screening for potential drug interactions and electrolyte abnormalities may also help lead to safer therapies, potentially preventing the development of ventricular arrhythmias.

References 1. What clinicians should know about the QT interval. Roden DM. Drug-induced prolongation of the QT interval. N Engl J Med. Drug induced QT prolongation and torsades de pointes. Darpo B. Spectrum of drugs prolonging QT interval and the incidence of torsades de pointes.

Eur Heart J Supplements. Chiang C. Drug-induced long QT syndrome. J Med Biol Eng. Frothingham R. Rates of torsades de pointes associated with ciprofloxacin, ofloxacin, levofloxacin, gatifloxacin and moxifloxacin.

Antimicrobial safety: focus on fluoroquinolones. Clin Infec Dis. Taylor DM. Antipsychotics and QT prolongation. Acta Psychiatr Scand. Anti-psychotic related QTc prolongation, torsades de pointes and sudden death.

Taylor D. Ziprasidone in the management of schizophrenia: the QT interval issue in context. CNS Drugs. Kupec IF. Seldane and generic terfenidine withdrawn from market. Feb 27, Available at: www. Tricyclic antidepressants, QT interval prolongation and torsades de pointes. Bauman JL. Rufinamide, a recently approved anticonvulsant, illustrates the current regulatory approach to drugs that shorten QT interval.

However, to further substantiate or confirm the safety of these drugs, their approval may well be conditional upon large-scale post-marketing studies with a focus on cardiac safety. Abstract ATP-dependent potassium channel openers such as pinacidil and levcromakalim have long been known to shorten action potential duration and to be profibrillatory in non-clinical models, raising concerns on the clinical safety of drugs that shorten QT interval.